ECE2024 Eposter Presentations Thyroid (198 abstracts)
Marine-lenhart syndrome: a rare cause of hyperthyroidism
Mohamed Khairi Arous 1 , Houcem Elomma Mrabet 1 , Fadia Boubaker 1 , Mariem Souissi 1 , Baha Zantour 1 , Wafa Alaya 1 & Mohamed Habib Sfar 1
1University Hospital Taher Sfar, Endocrinology and Internal medicine Department, Mahdia, Tunisia
Background: Marine-Lenhart syndrome (MLS) is defined by the coexistence of Graves’ disease and a hyperactive nodule or multinodular goiter. Although rare, its diagnosis by functional imaging coupled with ultrasound is necessary in order to propose a radical treatment. We report the case of a patient followed for hyperthyroidism related to a SML.
Case presentation: A 52-year-old patient consulted for a picture of thyrotoxicosis associating tremor, weight loss, polyphagia, irritability and thermophobia. Physical examination revealed a small goiter with a right lobar nodule and bilateral exophtalmia. Hormonal assessment showed a TSH at 0.002 mIU/l and FT4 at 47.1 pmol/l confirming peripheral hyperthyroidism. Anti-TSH receptor antibodies were positive at 40. The Graves’ disease was diagnosed confronted to the proptosis and the positivity of the antibodies. Neck ultrasound showed a hypervascularized goiter and two right lobar nodules classified EU-TIRADS III measuring 7.1 mm and 2.3 mm respectively. Scintigraphy showed an increased diffuse iodine uptake of the thyroid gland along with a partially extinctive thyroid nodule. The patient was put on 20 mg/d of thiamazol in preparation for a radical treatment by total thyroidectomy
Conclusions: The diagnosis of MLS is present in 2-4% of patients with MB; hence the inecessity of a neck ultrasound even in the presence of clinically or biologically obvious Graves’ disease, especially in the presence of a thyroid nodule. Scintigraphy is also required to characterize the nodule. The treatment of MLS is surgical, since resistance to synthetic antithyroid drugs is noted in these cases.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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